| NPI | 1881678878 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAVONDA L KEATING Sr Production Unit Mgr 410-933-6430 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical |
| Additional Taxonomies | 103T00000X Psychologist |
| Enumeration Date | 2005-12-02 |
| Last Update Date | 2022-07-21 |